Visual acuity of pseudophakic patients predicted from in-vitro measurements of intraocular lenses with different design

The optical quality of a set of IOLs (modeling set: one monofocal and two bifocals) was assessed through focus by the area under the modulation transfer function (MTFa) metric and related to the visual acuity (VA) defocus curves of pseudophakic patients implanted with said IOLs. A non-linear relationship between the MTFa and clinical VA was obtained with an asymptotic limit found to be the best VA achievable by the patients. Two mathematical fitting functions between clinical VA and MTFa were derived with high correlation coefficients (R-2 >= 0.85). They were applied to the MTFa obtained from a different set of IOLs with advanced designs (trial set: one extended range of vision -ERV-, one trifocal ERV and one trifocal apodized) to predict VA versus defocus of patients implanted with these IOLs. Differences between the calculated VA and the clinical VA for both fitting models were within the standard deviation of the clinical measurements in the range of -3.00 D to 0.00 D defocus. thus proving the suitability of the MTFa metric to predict clinical VA performance of new IOL designs. (C) 2018 Optical Society of America under the terms of the OSA Open Access Publishing Agreemen

Viscoat versus Visthesia during phacoemulsification cataract surgery: corneal and foveal changes

<p>Abstract</p> <p>Background</p> <p>Ophthalmic viscosurgical devices (OVDs) are widely used in phacoemulsification cataract surgery to maintain adequate intraocular space, stabilize ocular tissue during the operation and decrease the possible damage of the corneal endothelium. Our study has the purpose to compare the corneal and foveal changes of Viscoat and Visthesia in patients undergoing uneventful phacoemulsification cataract surgery.</p> <p>Methods</p> <p>Participants in our study were 77 consecutive patients, who were randomized into two groups based on type of OVD used during phacoemulsification: Viscoat or Visthesia. All patients underwent a complete ophthalmological examination i.e., measurement of best corrected visual acuity (BCVA) by means of Snellen charts, intraocular pressure examination by Goldmann tonometry, slit lamp examination, fundus examination, optical coherence tomography, specular microscopy and ultrasound pachymetry preoperatively and at three time points postoperatively (day 3, 15, 28 postoperatively). The differences in baseline characteristics, as well as in outcomes between the two groups were compared by Mann-Whitney-Wilcoxon test and Student's t-test, as appropriate.</p> <p>Results</p> <p>Intraoperatively, there was no statistically significant difference in the duration of the ultrasound application between the two groups, while Viscoat group needed more time for the operation performance. It is also worthy to mention that Visthesia group exhibited less intense pain than patients in Viscoat group. Postoperatively, there was a statistically significant difference in central corneal thickness, endothelial cell count and macular thickness between the two groups, but BCVA (logMAR) did not differ between the two groups.</p> <p>Conclusions</p> <p>Our study suggests that Viscoat is more safe and protective for the corneal endothelium during uneventful phacoemulsification cataract surgery, while Visthesia is in superior position regarding intraoperative pain. Patients of both groups acquired excellent visual acuity postoperative. Finally, this is the first study comparing OVDs in terms of macular thickness, finding that Visthesia cause a greater increase in macular thickness postoperatively than Viscoat, although it reaches normal ranges in both groups.</p

Prospective Randomized Single-Masked Study of Bilateral Isofocal Optic-Design or Monofocal Intraocular Lenses

Robert Edward T Ang,1 Pavel Stodulka,2 Francisco Poyales3 1Cataract and Refractive Surgery Department, Asian Eye Institute, Makati City, Philippines; 2Cataract and Refractive Surgery Department, Gemini Eye Clinic, Zlín and Gemini Eye Clinic, Prague, Czech Republic; 3Cataract and Refractive Surgery Department, Miranza IOA, Madrid, Madrid, SpainCorrespondence: Robert Edward T Ang, Cataract and Refractive Surgery Department, Asian Eye Institute, 8th Floor PHINMA Plaza, Rockwell Center, Makati City, Philippines, Email [email protected]: To assess refractive and visual outcomes of bilateral implantation of an isofocal optic-design intraocular lens (IOL) or a monofocal IOL following cataract surgery.Methods: A total of 127 patients were recruited into a prospective, single-masked, randomized trial. Sixty-five patients bilaterally implanted with the Isopure Isofocal IOL and 62 patients with the Micropure Monofocal IOL were followed for 4– 6 months. Refraction, monocular and binocular uncorrected-distance-visual acuity, corrected-distance-visual acuity (CDVA), uncorrected-intermediate-visual acuity and distance-corrected-intermediate-visual acuity (DCIVA, 66/80 cm), uncorrected-near-visual acuity, and distance-corrected-near-visual acuity (DCNVA, 40 cm) were evaluated. Binocular defocus curve, binocular contrast sensitivity (photopic, mesopic with/without glare), and glare and halo phenomena were also measured.Results: 99.23% of eyes were within ± 1.00D and 84.62% of eyes within ± 0.50D for the Isopure patients and 98.39% and 82.26% for the Micropure patients, respectively. The mean spherical-equivalent was − 0.06 ± 0.36D and 0.10 ± 0.32D for the Isopure and Micropure patients, respectively. 98.5% and 100% of patients implanted with the Isopure and Micropure IOLs showed a cumulative binocular CDVA value ≥ 20/20, respectively. 80% and 67.70% of patients implanted with the Isopure presented a binocular DCIVA ≥ 20/25 at 80 and 66 cm, respectively. These percentages were 46.8% and 40.3% with the Micropure IOL, respectively. For Isopure, 7.7%, 30.8%, and 58.5% of patients presented a DCNVA ≥ 20/25, ≥ 20/32 and ≥ 20/40, respectively. These values were lower for the Micropure: 1.6%, 19.4% and 46.8%, respectively. Defocus curves showed similar good visual acuity at distance for both lenses with better intermediate vision for the Isopure. Both groups presented good contrast sensitivity, and the size and intensity of halo and glare phenomena were similar between the two. No adverse-events were reported.Conclusion: Our trial shows that both IOLs provide excellent visual acuity and contrast sensitivity for far vision with similar photic phenomena, and the Isopure IOL improved unaided intermediate vision performance.Keywords: intraocular lens, phacoemulsification, cataract, visual acuity, defocus curv

In vivo subjective and objective longitudinal chromatic aberration after bilateral implantation of the same design of hydrophobic and hydrophilic intraocular lenses

10 págs.; 5 figs.; 3 tabs.Purpose To measure the longitudinal chromatic aberration in vivo using psychophysical and wavefront-sensing methods in patients with bilateral implantation of monofocal intraocular lenses (IOLs) of similar aspheric design but different materials (hydrophobic Podeye and hydrophilic Poday). Setting Instituto de Optica, Consejo Superior de Investigaciones Cientificas, Madrid, Spain. Design Prospective observational study. Methods Measurements were performed with the use of psychophysical (480 to 700 nm) and wavefront-sensing (480 to 950 nm) methods using a custom-developed adaptive optics system. Chromatic difference-of-focus curves were obtained from best-focus data at each wavelength, and the longitudinal chromatic aberration was obtained from the slope of linear regressions to those curves. Results The longitudinal chromatic aberration from psychophysical measurements was 1.37 diopters (D) ± 0.08 (SD) (hydrophobic) and 1.21 ± 0.08 D (hydrophilic). From wavefront-sensing, the longitudinal chromatic aberration was 0.88 ± 0.07 D and 0.73 ± 0.09 D, respectively. At 480 to 950 nm, the longitudinal chromatic aberration was 1.27 ± 0.09 D (hydrophobic) and 1.02 ± 0.13 D (hydrophilic). The longitudinal chromatic aberration was consistently higher in eyes with the hydrophobic IOL than in eyes with the hydrophilic IOL (a difference of 0.16 D and 0.15 D, respectively). Similar to findings in young phakic eyes, the longitudinal chromatic aberration from the psychophysical method was consistently higher than from wavefront-sensing, by 0.48 D (35.41%) for the hydrophobic IOL and 0.48 D (39.43%) for the hydrophilic IOL. Conclusion Longitudinal chromatic aberrations were smaller with hydrophilic IOLs than with hydrophobic IOLs of the same design. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.Supported by PhysIOL, Liege, Belgium, European Research Council-2011-AdC 294099 (Dr. Marcos), Spanish Government grant FIS2011-25637 (Dr. Marcos), Consejo Superior de Investigaciones Cientıficas Junta de Ampliacion de Estudios-Preprograms, and Ministerio de Ciencia e Innovacion Formacion de Profesotado Universitario predoctoral fellowship (Dr. Vinas).Peer Reviewe

Longitudinal chromatic aberration in patients implanted with trifocal diffractive hydrophobic IOLs

PURPOSE: To measure the in vivo longitudinal chromatic aberration (LCA) from the chromatic difference of focus (480 to 700 nm) using psychophysical methods in patients bilaterally implanted with a hydrophobic trifocal intraocular lens (IOL). METHODS: Psychophysical best focus was measured in both eyes at different wavelengths (480 to 700 nm) and at three different viewing distances (0.00, +1.75, and +3.50 diopters [D]) using a custom-developed polychromatic adaptive optics set-up provided with a supercontinuum laser, a Hartmann-Shack wavefront sensor, a deformable mirror, a motorized Badal system, a pupil monitoring system, and a psychophysical channel with monochromatically illuminated stimuli. Measurements were performed on 10 patients (20 eyes) bilaterally implanted with hydrophobic trifocal diffractive IOLs (FineVisionHP POD F GF; PhysIOL). LCA was computed from the chromatic difference of focus curves as the difference between 480 and 700 nm at near, intermediate, and far. RESULTS: The LCA from psychophysical measurements was significantly higher for far vision (0.99 ± 0.06 diopters [D]), than for intermediate (0.67 ± 0.10 D) and near (0.23 ± 0.08 D) vision (one-way analysis of variance, P < .05). CONCLUSIONS: LCA for far vision was significantly higher than for intermediate and near vision in hydrophobic trifocal diffractive IOLs, in agreement with a previous study with the same optical design but hydrophilic material IOLs. The LCA for the hydrophobic IOL is slightly higher than for the hydrophilic IOL at far. Different combinations of refractive and diffractive LCA will allow optimizing IOL designs to improve polychromatic image quality.Supported by Spanish Government Grant No. FIS 2017-84753 to Dr. Marcos, and FPU Predoctoral Fellowship No. FPU16/01944 to Ms. Aissati

Chromatic aberration in patients implanted with hydrophilic and hydrophobic monofocal and FineVision trifocal IOLs measured in vivo

The 36th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), 22-26 September 2018 in the Reed Messe, Vienna, Austria. --.https://www.escrs.org/vienna2018

In vivo measurement of longitudinal chromatic aberration in patients implanted with trifocal diffractive intraocular lenses

11 pags., 1-3 figs., 1 tab.PURPOSE: To measure the longitudinal chromatic aberration (LCA) by both psychophysical methods and in vivo double-pass retinal imaging in patients bilaterally implanted with trifocal diffractive intraocular lenses (IOLs). METHODS: Measurements were performed with a polychromatic adaptive optics system provided with a supercontinuum laser, a Hartmann-Shack wavefront sensor, a deformable mirror, a motorized Badal system, a pupil monitoring system, a double-pass retinal imaging channel, and a psychophysical channel with monochromatically illuminated stimuli. Ten patients (20 eyes) bilaterally implanted with hydrophilic trifocal diffractive IOLs (POD F [FINeVision]; PhysIOL, Liege, Belgium) participated in the study. Measurements were performed in both eyes at three different viewing distances (0.00, +1.75, and +3.50 diopters [D]). Subjective best focus of monochromatic stimuli at five wavelengths (480 to 700 nm) was obtained using the Badal system. Best focused images of through-focus double-pass image series were obtained at three wavelengths (480 to 700 nm). LCA was computed from chromatic difference of focus curves (objective and subjective) as the difference between 480 and 700 nm at near, intermediate, and far. RESULTS: The average subjective LCA was 0.82 ± 0.05 D for far, 0.27 ± 0.15 D for intermediate, and 0.15 ± 0.15 D for near. The average objective LCA was 0.72 ± 0.10 D for far, 0.19 ± 0.15 D for intermediate, and 0.07 ± 0.17 D for near. CONCLUSIONS: Objective LCA was lower than subjective LCA, which was in agreement with previous studies on patients with phakic and monofocal IOLs. In vivo measurements of LCA enable understanding of the relative contribution of refractive and diffractive LCA and will eventually optimize IOL designs to improve polychromatic image quality.Supported by European Research Council ERC-2011-AdG-294099; Spanish Government FIS2014; collaborative agreement with PhysIOL (Liege, Belgium).Peer Reviewe

In vivo measurement of longitudinal chromatic aberration with multifocal diffractive intraocular lenses.

ARVO 2017, Baltimore, MD, May 7-11, 2017Longitudinal Chromatic Aberration (LCA) plays an important role on polychromatic optical quality, and it is particularly relevant in subjects implanted with diffractive intraocular lenses (IOLs), where the chromatic aberration of the ocular elements and the refractive component of the IOL are added to the chromatic effects of the diffractive design. We used a custom polychromatic Adaptive Optics (AO) system to measure the LCA by both psychophysical methods and in vivo double-pass (DP) retinal imaging in patients bilaterally implanted with hydrophilic trifocal diffractive IOLs.Peer Reviewe

In vivo measurement of longitudinal chromatic aberration in patients implanted with the FineVision Trifocal IOL

XXXV Congress of the European Society of Cataract and Refractive Surgeons, Feira Internacional de Lisboa, Portugal, 7-11 October 2017. -- http://lisbonvenues.pt/en/fil/The eye¿s optical quality is affected by both monochromatic and polychromatic aberrations. In patients implanted with multifocal diffractive IOLs the longitudinal chromatic aberration is dependent upon the dispersion properties of the ocular elements and those of the IOL material as well as the diffractive design. We used a custom polychromatic Adaptive Optis (AO) system to measure the LCA -subjective and objective double-pass (DP) retinal imaging- in patients bilaterally implanted with hydrophilic trifocal diffractive IOLs (FineVision, PhysIOL, Belgium)Peer Reviewe